Experts raise alarm on Heart Failure; call it 'biggest silent killer'

New Delhi , Sept. 29 : By the year 2020, the burden of cardiovascular diseases (CVDs) in India is projected to surpass that of any other country in the world.

On the occasion of World Heart Day, which would be observed on 29th September, experts from the country have urged to pay more attention to the early signs and symptoms that are indicative of an underlying heart disease, to ensure early diagnosis.

In India, Heart ailments are the leading cause of mortality, due to key challenges in cardiac care like inadequate facilities, inaccessibility, and lack of awareness.

Latest statistics suggest that cardiovascular diseases (CVDs) account for more than half of the mortality of the 9.8 million deaths due to non-communicable diseases (NCDs).

It has been noted that amongst other CVDs, Heart Failure has emerged as an epidemic in India accounting for 46 percent mortality due to cardiac reasons, within one-year of diagnosis. Our country is home to estimated 5.4 million people living with Heart Failure who face high risk of hospitalization, death and poor quality of life.

According to experts, enough attention has not been paid to Heart Failure and thus the condition has been silently and rapidly killing one-third of patients during hospital admission and one-fourth within 3 months of diagnosis.

Dr. Shirish (M.S.) Hiremath, President, Cardiological Society of India, said, "With the burden of Heart Failure snowballing in India and the associated high death rates, it is necessary to prioritize heart failure as a cardiovascular disease. The need of the hour is, coming together of all stakeholders to develop a community level approach to raise awareness about this condition, which is often used interchangeably with Heart Attack, or seen as an aftermath of the latter."

Despite the name, experts clarified that 'Heart Failure' does not mean the heart is quitting. It means that the weakened heart muscle is not pumping blood efficiently enough to meet the oxygen and nutritional demands of an individual's body.

Risk factors for Heart Failure include a history of coronary artery disease (CAD), heart attack, high blood pressure, heart valve disease, cardiomyopathy, lung disease, diabetes, obesity, alcohol and drug use and family history of heart diseases.

Common symptoms that should raise an alarm, include shortness of breath, tiredness, swelling in the ankles, legs and abdomen, loss of appetite, sudden weight gain, rapid heartbeat, confusion or dizziness and frequent urination.

Dr. Sundeep Mishra, Professor of Cardiology, AIIMS, New Delhi, said, "In India, Heart Failure occurs a decade earlier than people in western countries, with the average age being 59 years.Lack of awareness, out of pocket expenditure and lack of infrastructure are corroborating to the increase in disease prevalence. However, the availability of new treatment options like sacubitril/valsartan - combination of two existing blood-pressure-reducing medications - are found to be highly effective. It achieved a substantial 20-percent reduction in death or repeat hospitalization, which is a huge benefit as compared with the currently available therapies.

The country has undergone rapid epidemiological and demographic transitions in the last 2 decades. As a result, the burden of Heart Failure in India has increased by nearly 140% from 1990 to 2013 .

With increasing life style deviation and spiking stress, its catchment area is ominously increasing, taking even youngsters in its grip. The mean age of heart failure patients in India is 59 years which is approximately 10 years younger than patients in US and Europe.

Data from low-income and middle-income countries like India suggested that mortality in patients with heart failure in these countries is greater than that in high income countries. The marked variation in mortality is attributed to low awareness, economic disparity, ease of access to high quality healthcare facilities, environmental and genetic factors.

Timely diagnosis of the condition and lifestyle modifications coupled with advanced treatment management protocols are required to curb its growing incidence reducing the associated hospitalization, mortality and morbidity.